Abstract
The third issue in the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, Spotlight series focuses on health care expenditures and payers. NCHS releases the latest data on health insurance coverage, with estimates for January through June 2016. The Survey of Residential Care Communities updates estimates on this growing segment of long-term health care. NCHStats, a blog on the NCHS website, highlights new data and provides a guide to NCHS data resources.
Latest Spotlight Focuses on Health Care Expenditures and Payers
The September issue of Health, United States Spotlight 1 is the third issue in this quarterly infographics series, which presents selected data from the annual report on the nation’s health. Health, United States is produced by NCHS using data from government and private sources to present an overview of national health trends. This issue features indicators from the report’s health care expenditures and payers’ subject area.
Key findings from the latest Spotlight show that in 2015, 20.6% of people aged <65 had Medicaid coverage, up from 12.9% in 2005. Children aged <18 were >3 times as likely (39.9%) as adults aged 18 to 64 (13.2%) to be covered by Medicaid in 2015. For both age groups, Medicaid coverage increased during the past decade. In 2005, 27.2% of children aged 0 to 17 and 7.2% of adults aged 18 to 64 were covered by Medicaid. Medicaid coverage includes coverage by Medicaid as well as state-sponsored plans or the Children’s Health Insurance Program. Data on Medicaid coverage came from the National Health Interview Survey, a large-scale general purpose interview survey of the nation’s civilian, noninstitutionalized population.
Another topic addressed in this issue of Spotlight is Medicare managed care, based on data from the Centers for Medicare & Medicaid Services’ enrollment database. In 2014, 3 of every 10 Medicare enrollees were in managed care, such as health maintenance organizations and preferred provider organizations. Enrollment in managed care increased from 13.0% in 2004 to 29.9% in 2014. The percentage of Medicare enrollees in managed care varied by state, from 0.9% in Arkansas to 51.8% in Minnesota. State variation reflected the availability of managed care in each state and the enrollees’ choice among available options.
Data on prescription drug spending, which increased from $192.8 billion in 2004 to $297.7 billion in 2014, are also highlighted in Spotlight. Prescription drug spending has risen in recent years, with a 12.2% increase from 2013 to 2014 after a steady 4.4% average annual growth beginning in 2004. The funding sources for prescribed drugs also changed from 2004 to 2014. Medicare accounted for 1.7% of drug spending in 2004 and increased to 29.0% in 2014. However, spending by all other funding sources for prescribed drugs (eg, private insurance, Medicaid, out-of-pocket sources) declined.
Previous issues of Spotlight highlighted health status and determinants and selected health indicators. All issues are available at http://www.cdc.gov/nchs/hus/hus_infographic.htm.
Latest Estimates of Health Insurance Coverage in the United States
A new NCHS report, “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-June 2016,” presents the latest estimates of health insurance coverage from its National Health Interview Survey (NHIS). 2 The survey asked whether respondents had health insurance coverage at the time of the interview, at any time during the year, and for >1 year. The findings were analyzed by population characteristics (age, race/ethnicity, income) and type and source of health insurance.
In the first half of 2016, 28.4 million (8.9%) people of all ages were uninsured at the time of interview, which was 20.2 million fewer uninsured people than in 2010 (16.0%). The report examined patterns of coverage for people aged <65 because most adults aged ≥65 are covered under Medicare. Only 0.6% of those aged ≥65 lacked insurance coverage from January through June 2016. From 2010 to 2016, lack of coverage declined from 7.8% to 5.0% for children aged 0 to 17 and from 22.3% to 12.4% for adults aged 18 to 64. By race/ethnicity, the percentage of people aged <65 who lacked health insurance coverage declined from 2010 to the first 6 months of 2016 for Hispanic, non-Hispanic white, and non-Hispanic black people. Among Hispanic people, the percentage of those who lacked coverage decreased from 31.9% in 2010 to 19.0% in the first half of 2016. Among non-Hispanic white people, the percentage of those who lacked coverage decreased from 13.7% in 2010 to 7.5% in 2016; for non-Hispanic black people, the percentage decreased from 20.8% in 2010 to 11.6% in 2016.
The report also presents data on the type and source of health insurance coverage. From January to June 2016, among adults aged 18 to 64, 12.4% were uninsured at the time of interview, 20.0% had public health insurance, and 69.2% had private health insurance. During the same period, among children aged 0 to 17, 5.0% were uninsured, 42.7% had public health insurance, and 53.9% had private health insurance. Among adults aged 18 to 64, the percentage with coverage through the Health Insurance Marketplace or state-based exchanges rose slightly from 4.8% (9.3 million) in the second quarter of 2015 to 4.8% (9.4 million) in the second quarter of 2016.
This report is updated quarterly and is part of the NHIS Early Release Program, which releases updated selected estimates that are available from the NHIS website at http://www.cdc.gov/nchs/nhis.htm.
Residential Care Community Survey Updated
As part of the 2014 National Study of Long-term Care Providers, the component on residential care communities was the first major nationwide survey of this growing segment of long-term care. Data from the residential care community survey described the characteristics of the communities, characteristics of residents, and information on the services and care provided. The survey, which was fielded in late 2016, will expand the data available on residential care communities. The 2016 survey sampled 11 600 assisted living and similar residential care communities, which provide care to nearly 1 million people, most of whom are aged ≥85. Based on a new methodology, the survey was completed and submitted through the Internet to reduce response burden. Two versions of the questionnaire were used to expand the types of data collected without increasing response time. Data will be available in late 2017. Data users can be notified of the release of the findings by signing up at the survey’s listserv at http://www.cdc.gov/nchs/nsltcp/longterm_listserv.htm. Data products are released on the NCHS website and may be viewed or downloaded free of charge. 3
NCHS Blog Highlights, Current Releases, and NCHS News
NCHStats is a blog that NCHS posts on its website to provide information on current data releases, new program activities and events, excerpts from the NCHS and Centers for Disease Control and Prevention Twitter accounts, special interviews, and question-and-answer articles with NCHS authors. NCHStats includes an index to NCHS data topics, data collection systems, and other guides to NCHS data resources. 4